Gender Bias in Diagnosing Anger: Batterer or Borderline?

Some people exress anger in a way that is toxic, spreading negative energy onto everyone around them. I like that word "toxic" because it can refer equally to verbally abusive men and to verbally abusive women. Toxicity, whether it is spewed by a man or a woman, can kill; toxicity kills personal emotional well-being and also kills relationships.

Most clinical labels for anger are assigned with gender bias. We name raging women borderlines and raging men either abusive, bipolar, narcissistic or sociopathic. By contrast, the term "toxic" has no gender stereotype attached to it.

What about the term narcissism? Does that term also invite gender bias in diagnosis?

The label narcissistic does fairly well in the gender realm but not well enough.

On the one hand, anyone, male or female, who is self-aborbed, unable or unwilling to take others' concerns into mind, and poor at listening to others can easily earn this label, at least wtih regard to narcissistic habits.

On the other hand, when it comes to narcissism as a diagnosis for character disorders, men disproportionately get labeled as narcissists whereas women with essentially the same symptom picture will tend to receive a borderline personality disorder diagnosis. Do men with a narcissist personality disorder react with excessively strong emotions, sometimes seeing threat and criticism where it doesn't even exist? For sure Do women with a borderline personality tend to behave narcissistically. You can bet your bottom dollar on that one.

When about gender bias in diagnosis of excessive anger?

There's no simple label for excessive anger in the DSM, as I've written earlier. Too bad because if anger, like anxiety and depressive, was a potential diagnostic label, that would solve the dilemma.

Interestingly also, whereas women seem to get most of the borderline labeling, men get most of the abuser label. For sure, borderline women can be profoundly verbally abusive to everyone that has to deal with them on more than a public and superficial level. They often look attractive, sometimes seductively so, at work and with friends. It's at home that the tongue lashings (and sometimes also physical attacks) become violent. Read reports from adults who grew up with a borderline mother if you have questions about the extent of borderline's abusive behavior even if these individuals seldom get labeled "abusive."

Another trend: If they are male and have too much anger, they get treated with medications and labeled bipolar. If they are female, their toxic anger again is more likely to be considered a sign of borderline features.

Here's another one: In a recent study of gender impacts on ADHD diagnosis, clinicians were twice as likely to assign this label if they thought that the client description they were reading was of a boy than of a girl. Hmmm..

"Interesting. I was just discussing this with my husband this morning, talking about the fact that there are more discussions about BPD mothers than there are about BPD fathers. I'm pretty sure I know why. (I grew up with a BPD mother and an Aspberger's father.)

Surveys of prison populations show that prisoners have a very high incidence of personality disorders, and that male prisoners are more likely to have anti-social personality disorder and females are more likely to have BPD. I think the difference is testosterone levels. Empathy-less males are more likely to become physically violent, and females are more likely to be emotionally and psychologically violent. Physical violence is a much shorter route to prison. So, I think that people are far more likely to still be in the custody of an empathyless mother than in the custody of an empathyless father…"

My question is whether men are more likely to "have" anti-social personality disorders, or whether that's the label we give to men who act out in disregard of social norms, whereas women with similar behaviors get labeled borderline personality disorder.

I'm a firm believer in the idea that culture deeply shapes the gender roles we take up as we grow older. A two year old can already have gendered toy preferences even though there's nothing biological about blue vs pink. If you start from a seed of overwhelming anger and add the very invasive way societal beliefs about gender shape our most fundamental behavior, I'm not surprised that there is a gender difference in the way that anger issue expresses itself.

Society does seem to equate violence with the masculine. Although emotionally unstable or hysterical with the feminine.

As for adhd yeah well, if boys are still brought up to explore, to play, to be adventurous and all that fun stuff no wonder. Imagine after all that being stuck in a classroom, needing to be still quiet and disciplined for hours on end!!!

Girls normally have been taught these skills from the beginning.

I'm probably assuredly out of date, but I guess some of these biases still factor heavily no???

Seems like calling this behavior "abusive" makes the most sense. Emotional, verbal, and physical abuse are all abuse, hurting another person. "Toxic" seems like a weird term to me, as I've known people I would consider toxic who weren't abusive per se... like someone who is constantly in a bad mood, constantly complains or has something negative to say. Never heard of toxic as being a clinical term. I've also known people who were narcissistic to a fault but not abusive. I would say my mother suffered from narcissism and she did have clinical depression, possibly just clinical depression that was so bad she couldn't see past the end of her own nose. If we had a problem or needed her help it was always "woe is me" never "how are you feeling?" not once that I remember. I've also heard of men who felt they were suffering from borderline personality disorder but couldn't get the diagnosis or the treatment. I think it does sort of make sense to have male and female clinical labels due to gendered behavior, as long as it's well recognized that the labels can also cross genders, if uncommonly.

These comments are clarifying for me that labels that refer to specific behaviors, e.g., verbal abuse, are more helpful that those that claim to refer to a syndrome (e.g., borderline). There's too much variability in broader categories.

The description of narcissism in your mother is especially poignant: "If we had a problem or needed her help it was always "woe is me" never "how are you feeling?" not once that I remember."

I think that the behavior descriptions have gender bias. But, to me, abuse is abuse -- whether physical or mental/emotional. Anger is anger no matter whether it is expressed physically or verbally/emotionally.

I also think that some diagnoses are seen as so "patient-damaging" that they are not used and instead the diagnosing professional might merge one type of disorder into another to avoid creating hopelessness for the patient.

The distinctions between "high functioning borderlines", "(low functioning) borderlines", "malignant narcissists" and "psychopaths" have been a topic discussion topic in another forum.

I think that these label are both with gender bias and with "hopelessness aversion".

Some people consider Jodi Arias (sp?) a borderline -- but she seemed to be more of a psychopath.

Can/should these behaviors be characterized as disorder by the degree of impulse control exercised rather than by gender or aversion to stigmatizing people with specific diagnoses?

Violence is really the outcome of the lack of impulse control. The type of violence is really a matter of "capacity and opportunity", it seems to me. Is self-directed physical violence/abuse really that much of a distinguishing factor when outward directed emotional/verbal violence/abuse is also present?

Males can be borderlines. And all of these Cluster Bs share so many characteristics. But more puzzling to me is whether low functioning borderlines and high functioning borderlines both are borderlines?

I came across this study that explains why, until recently, men evidencing the traits associated with bpd have been diagnosed as "antisocial pd", and concludes that there is no difference in prevalence by gender: men and women have borderline pd in virtually equal numbers.